ArticleCirculation2026
Effect of Aficamten on Cardiac Structure and Function in Patients with Symptomatic Nonobstructive Hypertrophic Cardiomyopathy.
Article in Circulation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06081894 (A Phase 3, Multi-Center, Randomized, Double-Blind Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Placebo in Adults With Symptomatic Non-Obstructive Hypertrophic Cardiomyopathy), which is not on this map. Not yet cited in PubMed.
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A Phase 3, Multi-Center, Randomized, Double-Blind Trial to Evaluate the Efficacy and Safety of Aficamten Compared to Placebo in Adults With Symptomatic Non-Obstructive Hypertrophic Cardiomyopathy
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48 authors.
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Abstract
backgroundAficamten significantly improved both functional capacity and patient-reported health status in patients with symptomatic nonobstructive hypertrophic cardiomyopathy in the phase 3 randomized, placebo-controlled ACACIA-HCM trial (Assessment Comparing Aficamten to Placebo on Cardiac Endpoints in Adults with Non-Obstructive HCM; NCT06081894). Serial echocardiographic examinations may provide insights into the mechanisms underlying the therapeutic effect of aficamten in this prespecified exploratory analysis.
methodsSymptomatic patients with nonobstructive hypertrophic cardiomyopathy were randomized 1:1 to receive aficamten (range, 5-20 mg, titration based on left ventricular [LV] ejection fraction) or placebo for up to 72 weeks (end of treatment). The effect of aficamten on echocardiographic measures at 36 weeks (time of primary end point) and end of treatment was assessed with linear regression models adjusted for baseline values, intracavity obstruction, and baseline atrial fibrillation.
resultsAmong 517 participants (mean±SD: age, 55±16 years; 54% female, 75% White, 13% Asian), mean baseline LV ejection fraction was 68±4% with abnormal measures of diastolic function. Compared with placebo, aficamten decreased LV ejection fraction (-4.6% [-5.5, -3.6];
conclusionsIn patients with nonobstructive hypertrophic cardiomyopathy, aficamten improved echocardiographic measures of diastolic function. These findings suggest that the benefits of aficamten extend beyond the effects of LV outflow tract gradient reduction observed in prior studies. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT06081894.
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